Abstract
To compare 3D-Fast Gray Matter Acquisition with Phase Sensitive Inversion Recovery (3D-FGAPSIR) with conventional 3D-Short-Tau Inversion Recovery (3D-STIR) and sagittal T1-and T2-weighted MRI dataset at 3 Tesla when detecting MS spinal cord lesions. This prospective single-center study was approved by an institutional review board and enrolled participants from December 2016 to August 2018. Two neuroradiologists blinded to all data, individually analyzed the 3D-FGAPSIR and the conventional datasets separately and in random order. Discrepancies were resolved by consensus by a third neuroradiologist. The primary judgment criterion was the number of MS spinal cord lesions. Secondary judgment criteria included lesion enhancement, lesion delineation, reader-reported confidence and lesion-to-cord-contrast-ratio. A Wilcoxon's test was used to compare the two datasets. 51 participants were included. 3D-FGAPSIR detected significantly more lesions than the conventional dataset (344 versus 171 respectively, p<0.001). Two participants had no detected lesion on the conventional dataset, whereas 3D-FGAPSIR detected at least one lesion. 3/51 participants had a single enhancing lesion detected by both datasets. Lesion delineation and reader-reported confidence were significantly higher with 3D-FGAPSIR: 4.5 (IQR 1) versus 2 (IQR 0.5), p<0.0001 and 4.5 (IQR 1) versus 2.5 (IQR 0.5), p<0.0001. Lesion-to-cord-contrast-ratio was significantly higher using 3D-FGAPSIR as opposed to 3D-STIR and T2: 1.4 (IQR 0,3) versus 0.4 (IQR 0,1) and 0.3 (IQR 0,1)(p = 0.04). Correlations with clinical data and inter- and intra-observer agreements were higher with 3D-FGAPSIR. 3D-FGAPSIR improved overall MS spinal cord lesion detection as compared to conventional set and detected all enhancing lesions.
Highlights
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system affecting both the encephalon and the spinal cord
Lesion delineation and reader-reported confidence were significantly higher with 3D-FGAPSIR: 4.5 (IQR 1) versus 2 (IQR 0.5), p
The aim of our study was to evaluate the detection of spinal cord lesions by 3D-FGAPSIR as compared to a conventional dataset including post contrast 3D-Short-Tau Inversion Recovery (3D-STIR), sagittal T2- and T1-weighted imaging (WI)
Summary
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system affecting both the encephalon and the spinal cord. The sensitivity of conventional imaging like T2-weighted imaging (WI) to show spinal cord lesions in MS is low, as demonstrated by radiological-pathological correlations [4]. This low sensitivity on sequences may be related to low lesion to normal cord contrast [5,6]. It might be one of the reasons for the poor correlation between clinical scores and the number of lesions detected. To compare 3D-Fast Gray Matter Acquisition with Phase Sensitive Inversion Recovery (3DFGAPSIR) with conventional 3D-Short-Tau Inversion Recovery (3D-STIR) and sagittal T1and T2-weighted MRI dataset at 3 Tesla when detecting MS spinal cord lesions
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